Psychedelic-Assisted Therapy: What Insights It Can Offer Patients with Cancer

As a hypnosis practitioner, I have experienced the unexpected capacity of my patient’s brains to modify pain, nausea, anxiety, and other causes of their distress. When I heard how psychedelic assisted therapy could relieve or even eliminate my patients’ existential distress, I needed to learn more. I attended a two-day course and interviewed one of the faculty members, a colleague of mine at DFCI, Dr. Yvan Beaussant. I find his work fascinating and want to share some of it with you here.

Introducing Dr. Yvan Beaussant

Dr. Yvan Beaussant, an instructor at Harvard Medical School and a palliative care physician and investigator, leads the psychedelic-assisted therapy research program at Dana-Farber Cancer Institute. Dr. Beaussant completed a master’s in ethics at Paris Descartes University and earned a Certificate in Psychedelic Therapies and Research from the California Institute of Integral Studies. His research examines the effects and mechanisms of psilocybin-, MDMA-, and ketamine-assisted therapies on depression, pain, and existential distress in patients with serious illness. In addition, Dr. Beaussant is deeply engaged in identifying and addressing barriers to equitable implementation of psychedelic-assisted therapy in serious illness care. You can learn more about his work at psychedelics.dana-farber.org.

Inspiration for Exploring Psychedelic Therapy

Janet: I’m curious about what first drew you as a palliative care physician to explore psychedelic-assisted therapy for patients.

Yvan: My interest began early in my career in France. During residency in hematology, as I transitioned to palliative care, I researched uncertainty in medical decision-making—how patients and physicians navigate choices when cancer progresses. That work revealed a profound gap: existential distress is common, yet our tools to address it are limited.

Around 2013–14, I encountered emerging research on psychedelics in cancer care, building on studies from the 1950s and ’60s. I was struck by their potential to accelerate therapeutic processes—helping patients reconnect with what matters, find coping strategies, and experience reconciliation, forgiveness, and connection. It became clear this approach could fill a critical gap in palliative medicine, and I committed to exploring it further.

Lessons from Early Research

Janet: You’ve already done a lot of studies, the ACCEPT study and the PATH study. What have you learned about safety, feasibility, and patient experiences? Did they add up to what you were hoping for?

Yvan: My early work focused on understanding how clinicians and researchers viewed psychedelic-assisted therapy in serious illness. I brought together oncologists, psychiatrists, psycho-oncologists, and spirituality researchers to set priorities and integrate psychedelics into palliative care studies. This led to the ACCEPT study, where I interviewed 28 of 30 participants receiving a single 25 mg dose of psilocybin in small group sessions with structured preparation and integration. Outcomes were striking: 80% showed substantial improvement in depression, 50% achieved remission, and pain intensity often decreased. Participants reported profound existential insights, a sense of belonging, and enhanced capacity to face uncertainty. So, yes, these findings confirmed both the feasibility and transformative potential of psilocybin in palliative care.

Building on that work, the PATH study—recently published in BMJ S&P—allowed us to ask a different and more clinically challenging question: can psilocybin-assisted therapy be delivered safely and meaningfully to patients receiving hospice-level care? In PATH, we demonstrated that with careful screening, medical oversight, and a strong therapeutic container, psilocybin sessions were not only feasible but deeply valued by patients nearing the end of life. Many described reduced demoralization, greater peace, and improved relational presence in their final months.

In parallel, we are completing recruitment for a phase 2 study of psilocybin-assisted therapy for opioid-refractory cancer pain. This study reflects an evolution in our thinking—recognizing that pain in advanced cancer is rarely purely physical, but deeply intertwined with fear, meaning, and loss of agency. While we are still collecting the data, early experiences suggest that psilocybin may help patients transform their relationship to pain, even when analgesic options are limited. Together, these studies have reinforced for me that safety and feasibility are not the main barriers; the real work now is understanding mechanisms, refining indications, and building models that can responsibly bring this approach into routine cancer care.

Understanding the Pharmacology: Psilocybin versus MDMA

Janet: I know psilocybin works on different receptors in the brain than MDMA does. Maybe you could review that with us?

Yvan: Yes. We typically distinguish classic psychedelics, like psilocybin, LSD, or ayahuasca, from non-classic ones, like MDMA or ketamine. Classic psychedelics act primarily on serotonin receptors—specifically 5-HT2A (Figure A in Additional Resources below) and produce profound shifts in consciousness – often non-verbal, deeply physical, emotional, visual, or spiritual. They take patients beyond the usual framework of language and cognition, which can facilitate insights and emotional processing that aren’t easily accessed otherwise.

MDMA, in contrast, is an empathogen. It works through release of serotonin (Figure B in Additional Resources below) as well as a lesser amount of oxytocin. Patients stay more verbally connected, access memories, and process difficult experiences with reduced fear and neurovegetative response. This makes it particularly useful for PTSD or other trauma or adjustment-related therapies. Patients can engage with challenging material—often relational or emotional—without becoming overwhelmed.

While our studies focus primarily on psilocybin in cancer care, I also collaborate on MDMA
tudies for patients and their significant others, exploring how this distinct pharmacology supports relational and emotional healing alongside physical illness.

The Importance of Commitment to Therapy

Janet: I want to clarify that this is assisted therapy, so does anyone who wants to use psilocybin needs to commit to engage in therapy?

Yvan: Absolutely—psilocybin therapy is always delivered within a therapeutic relationship. It’s not a medication you take on your own to “fix” a symptom. This distinction is important, because the experience can be intense. Psychedelics can bring up deep psychological material—grief, fear, or unresolved issues—that can feel confronting, especially if someone tries to push them away. In a recreational setting, that can be overwhelming, even panic-inducing.

In a therapeutic context, the drug is paired with structured psychotherapy. Patients commit to this process for a period of time, engaging with a therapist who supports them before, during, and after the session. The guidance helps them navigate difficult emotions, integrate insights, and ultimately transform their experience into something meaningful—whether that’s a renewed sense of peace, acceptance, or connection.

The Arc of Therapy

Janet: You’ve talked about the arc of the treatment. Can you describe the process in a bit more detail for us?

Yvan: Of course. The therapy unfolds across three phases: preparation, dosing, and integration. Preparation is crucial—it builds trust between the patient and therapist, sets intentions for what the patient hopes to gain, and introduces grounding or relaxation techniques to help navigate intense emotions that may arise. This phase ensures the patient feels safe, supported, and ready to engage deeply.

During the dosing session, participants typically lie in a comfortable, home-like environment with a carefully curated music program that mirrors the arc of the psychedelic experience. The therapist’s role is mostly silent but deeply supportive, encouraging patients to turn inward, engage with their emotions, and breathe through challenging moments.

Afterwards, there are two or three integration sessions—starting the day after, then a week later, and sometimes a third session—to help consolidate the experience, make sense of insights, and empower patients to continue their personal integration journey over weeks and months.

The Role of Music

Janet: You mentioned that music is an essential part of psychedelic assisted therapy. So, I’m curious how you discovered which music would be helpful, who chose it, and how did you assess its role in the process?

Yvan: Absolutely—music is central to the intervention. It’s not just background; we think of it as a “co-therapist” guiding emotional and imagery processes. Early LSD research at Spring Grove Hospital used classical music carefully selected to foster peak or mystical experiences. Building on that, I work with music therapist Lisa Summer, a mentee of Helen Boney, to create playlists tailored to each patient’s emotional baseline.

The music begins by offering comfort and grounding, helping patients feel safe as they face the unknown of psilocybin. Over the session, it progressively opens space for deeper, sometimes challenging emotions, while also inviting exploration of entirely new emotional landscapes. Instrumental music is key, as it avoids distracting cognitive activation. This approach supports patients in navigating fears and uncertainties, deepening the therapeutic process, and allowing for meaningful insights and emotional growth, all within a carefully guided, psychologically safe environment.

Who Might Benefit from Psychedelic Therapy

Janet: Are there certain types of cancer patients—or specific situations— you think are especially well-suited for referral to psychedelic-assisted therapy?

Yvan: In my experience, there are generally two types of patients who might be good candidates for psychedelic-assisted therapy.

The first group includes those experiencing significant distress—what we often call “total pain” in palliative care. This is the kind of suffering that doesn’t always respond to opioids and can involve a mix of physical, psychological, and existential challenges. Patients might be dealing with depression, anxiety, demoralization, or death anxiety, and facing the realities of their diagnosis, disease progression, or approaching end of life. These individuals may find meaningful benefit from this therapy.

The second group are what I think of as “seekers”—patients who aren’t necessarily in acute distress but are curious about exploring meaning, spiritual growth, or existential questions in the context of serious illness, aging, or end of life. For them, the focus is less on symptom relief and more on deepening their experience, fostering insight, and supporting personal growth.

But in both cases, the patients must be ready and willing to engage fully in the structured therapeutic process.

Scaling Psychedelic Therapy

Janet: Looking ahead, what do you think it would take to make psychedelic-assisted therapy more scalable—something that could be accessible and credible across the United States for the broader cancer population? Are we talking about specific types of research, training programs, or something else entirely?

Yvan: Accessibility is an interesting challenge. Scaling psychedelic-assisted therapy isn’t just about producing the drug—it’s about training enough skilled clinicians to guide patients safely through an intense, structured intervention. Think of it like surgery: there’s preparation, the procedure, and then support afterward to help patients integrate the experience. Yet, while complex, the safety and logistics are very manageable with proper models.

There is current research focusing on understanding which patients benefit from which modalities and how to measure outcomes effectively. But we also need to make these therapies culturally accessible. Those who might benefit most—often vulnerable populations—don’t always reach clinical trials, so factors like music, setting, and approach may need adaptation to different cultural contexts.

There’s also a spectrum of care: some patients need a full medical model, while healthier “seekers” may thrive with non-medical guidance. Finally, beyond medicine, the cultural and societal implications are enormous so thoughtful integration of both clinical rigor and cultural understanding will be key to scaling responsibly.

Set, Setting, and the Matrix of the Patient’s Experience

Janet: Is there anything you’d like to share that I haven’t asked you about?

Yvan: That’s a wonderful question. We haven’t talked a lot about set and setting which are central to psychedelic-assisted therapy. The “set” refers to the mindset someone brings into the experience—their preparation, intentions, and the trust they feel in the process. The “setting” is the environment itself, which can deeply influence how safe and meaningful the experience feels. These ideas extend beyond psychedelics, too; they remind us that a person’s mindset and surroundings shape how they experience serious illness, palliative care, and the end of life.

We also need to consider the broader “matrix” of a patient’s experience—the societal and cultural narratives that can amplify distress or resilience. Being thoughtful about mindset and environment allows us to create spaces where patients can feel supported, grounded, and seen. Attending to these dimensions helps ensure that interventions—whether psychedelic-assisted or medical—truly meet the needs of the whole person.

In Conclusion

A new frontier: In the not-too-distant future, with enough trained therapists, psychedelic assisted therapy will become more available for our patients suffering from existential distress.  And MDMA assisted therapies will be available for our patients suffering from PTSD from their cancer diagnoses, therapy, or recurrence. My hope is that the more you, their oncology clinicians, know about what’s available, the more comfortable you will be referring your patients to receive the extraordinary therapies that can ameliorate their extraordinary suffering.

Additional Resources

Figures A referred to above:

Figure B referred to above:

In my book:
Comprehensive Guide to Supportive and Palliative Care for Patients with Cancer
Fourth Edition, Johns Hopkins University Press, 2022. Page 420.

On my website: 
Agrawal M, Emanuel E, Richards B, et al.
Assessment of psilocybin therapy for patients with cancer and major depressive disorder
JAMA Oncol 2023;9:864-866

Rosa WE, Sager Z, Miller M, et al.
Top Ten Tips Palliative Care Clinicians Should Know About Psychedelic-assisted Therapy in the Context of Serious Illness
J Palliat Med 2022; 25:1273-1281

Whinkin E, Opalka M, Watters C, et al.
Psilocybin in Palliative Care: An Update
Curr Geriatr Rep. 2023;12:50-59

Other resources: 
Beaussant Y, Tarbi E, Nigam K, Miner S, Sager Z, Sanders J, Ljuslin J, Guérin B, Sholevar S, Roddy K, Tulsky JA, Agrawal M.
Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression.
Gen Hosp Psych. 2025 Sept; 97 (1) 175-184

Beaussant Y, Sager Z, Brennan C, Kristan I, Ljuslin M, Mazzola E, Macdonald D, Murphy ME, Nigam K, Rinaldi AD, Sanders J, Schaefer KG, Sholevar R, Summer L, Waliji-Banglawala A, Yudilevich-Espinoza S, Tulsky JA.
Psilocybin-assisted therapy for demoralisation in hospice patients: feasibility, safety and preliminary efficacy.
BMJ Supportive & Palliative Care Published Online First: 03 November 2025.